About BCDA
Every claim submitted to Medicare contains parts of a bigger story. These insights can get lost as patients move through a complex healthcare system.
Healthcare innovation to support value-based care
Beneficiary Claims Data API (BCDA) helps organizations participating in Alternative Payment Models reach value-based care incentives through accountable, integrated, and person-centered care.
BCDA is an Application Programming Interface (API) that helps organizations integrate Medicare claims data into their tracking, reporting, and performance systems. When providers learn about services their patients receive across the healthcare landscape, they provide more coordinated care.
What’s in the data
Similar to Claim and Claim Line Feeds (CCLF), BCDA data offers Medicare Parts A, B, and D data, but with key differences in file formatting and update frequency based partly on its foundation in Fast Healthcare Interoperability Resources (FHIR). FHIR standardizes data delivery into more universal categories that are easier for different systems to absorb and understand.
Learn more about using BCDA and CCLF files and mapping data between them with the Data Dictionary.
How BCDA fits into the claims data process
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Medicare enrollee receives care
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Provider submits Medicare claim
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BCDA shares partially adjudicated claims data
2-4 days after submission
Partially adjudicated claims haven’t been fully processed and approved yet. BCDA updates this data daily from the Integrated Data Repository (IDR).
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Medicare approves the claims
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BCDA shares adjudicated claims data
Typically 14 days after submission
BCDA receives updated adjudicated claims data from the IDR every weekend. In the event of a delay, we'll make an announcement in the BCDA Google Group with updates on when the data will be refreshed.
Improving timeliness with access to claims during processing
Normally, access to Parts A, B, and D data can be delayed during claims processing (adjudication). BCDA lets provider organizations see “partially-adjudicated” data before waiting for the process to complete.
Read the guide to partially adjudicated claims and their use cases to learn more about:
- Update frequency
- Resource types
- Eligible organizations
- Data Dictionary
Continuing innovation: BCDA v3
BCDA v3 consolidates data sources and FHIR conformance to help organizations reduce administrative friction, improve data quality, provide a better user experience, and more effectively realize the standardization benefits of FHIR interoperability.
Expanding reach to new models
BCDA continues to grow in availability. In 2026, its reach expanded to include the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions), GUIDE (Guiding an Improved Dementia Experience), and IOTA (Increasing Organ Transplant Access) models. As organizations within these models adopt BCDA, they’ll join an existing user community encompassing ACO REACH, KCC, and SSP participants.
What are the other CMS claims-based FHIR APIs?
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Claims Data to Part D Sponsors
The AB2D API provides stand-alone Prescription Drug Plan sponsors with claims data to enhance the use of medication and improve the long term health of enrollees.
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Blue Button
The Blue Button API enables enrollees to connect their Medicare claims data to the applications, services, and research programs they trust.
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Data at the Point of Care
The Data at the Point of Care (DPC) API enables healthcare providers with claims data to fill in gaps in patient history at the point of care and deliver high-quality care to Medicare enrollees.
